Intraperitoneal Gas Drain to Reduce Postsurgical Shoulder Tip Pain in Gynecological Laparoscopy

Abstract Background Operative gynecologic laparoscopy has become the preferred method for treating benign gynecologic diseases due to its minimally invasive nature and faster recovery compared to laparotomy. However, post-laparoscopic shoulder pain (PLSP) is a common complaint following laparoscopic surgeries, affecting patients' satisfaction and recovery. Various methods have been proposed to alleviate PLSP, but consensus on their effectiveness remains elusive. Aim of the Work This randomized controlled clinical trial aims to investigate the effect of gas drainage by intraperitoneal drain on shoulder pain in women after laparoscopic surgery in comparison to no drain use. Patients and Methods A randomized controlled clinical trial involving 120 female patients undergoing laparoscopic surgery was conducted to investigate the effect of intraperitoneal drainage on postoperative shoulder pain. The patients were divided into two groups: the study group (n = 60) with intraperitoneal drain placement, and the control group (n = 60) with routine technique and no drain use. Visual Analog Scale (VAS) scores were used to assess shoulder and abdominal pain at different postoperative time points. Results The study demonstrated that intraperitoneal drainage significantly reduced postoperative shoulder pain in the first 12 hours after surgery compared to the control group (p < 0.001 at 3 and 6 hours, p = 0.038 at 12 hours). However, no significant difference in shoulder pain was observed between the two groups at 24 hours post-surgery (p = 0.451). The need for postoperative analgesia was also lower in the drainage group (p < 0.001). These findings align with previous studies suggesting the efficacy of drainage in reducing shoulder pain after laparoscopic surgery. Conclusion This study demonstrates the effectiveness of intraperitoneal drainage in reducing post- laparoscopic shoulder pain during the first 24 hours after surgery, consequently reducing the need for postoperative analgesics. These findings support the outcomes of previous investigations, indicating that drain placement may be a valuable strategy to alleviate postoperative shoulder pain in women undergoing gynecologic laparoscopy.